NU641 EXAM 3 (REGIS) NEWEST 2025 ACTUAL EXAM|
NU 641 ADVANCED CLINICAL PHARMACOLOGY
EXAM 3 REVIEW WITH 200 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (BRAND NEW!!)
1. A 62-year-old with type 2 diabetes and heart failure with
reduced ejection fraction (HFrEF) has an HbA1c of 8.2% on
metformin. Which add-on agent has proven cardiovascular and
heart failure benefit?
A. Sitagliptin
B. Empagliflozin
C. Pioglitazone
D. Glimepiride
Answer: B – SGLT2 inhibitors (empagliflozin, dapagliflozin)
reduce HF hospitalization and CV death in HFrEF, regardless of
diabetes status.
1
,2. A patient with type 2 diabetes and eGFR of 35 mL/min is on
metformin. The nurse practitioner should:
A. Continue metformin at same dose
B. Reduce metformin dose by 50%
C. Discontinue metformin
D. Switch to metformin ER
Answer: C – Metformin is contraindicated when eGFR < 30
mL/min. At eGFR 30–45, continue with caution and reduced
dose. At 35, many guidelines suggest continue but monitor.
However, at 35, some sources recommend stopping or dose
reduction. Best answer: C is most conservative. (Clarify: eGFR <
30 absolute contraindication; 30–45 use with caution.)
3. A 55-year-old with type 2 diabetes and obesity (BMI 38) has
an HbA1c of 7.5% on metformin. Which medication provides the
2
,greatest weight loss?
A. Glipizide
B. Insulin glargine
C. Semaglutide
D. Sitagliptin
Answer: C – GLP-1 receptor agonists (semaglutide, liraglutide)
cause significant weight loss. Sulfonylureas and insulin cause
weight gain. DPP-4 inhibitors are weight neutral.
4. A patient with type 1 diabetes is on insulin lispro and insulin
glargine. He reports recurrent hypoglycemia 2 hours after meals.
The NP should:
A. Increase glargine dose
B. Decrease lispro dose or adjust timing
C. Add metformin
D. Switch to regular insulin
3
, Answer: B – Postprandial hypoglycemia suggests excessive
rapid-acting insulin (lispro) relative to meal size or timing. Adjust
prandial insulin.
5. A 70-year-old with type 2 diabetes and multiple falls is on
glimepiride. The NP should consider changing because:
A. Glimepiride causes weight loss
B. Sulfonylureas increase risk of hypoglycemia in elderly
C. Glimepiride is nephrotoxic
D. It causes lactic acidosis
Answer: B – Sulfonylureas (glimepiride, glyburide) cause
prolonged hypoglycemia, especially in elderly, those with CKD,
or irregular eating.
6. A patient on metformin for 5 years develops new-onset
fatigue and muscle cramps. Lab: BUN 32, Cr 1.5 (baseline 0.9),
4
NU 641 ADVANCED CLINICAL PHARMACOLOGY
EXAM 3 REVIEW WITH 200 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (BRAND NEW!!)
1. A 62-year-old with type 2 diabetes and heart failure with
reduced ejection fraction (HFrEF) has an HbA1c of 8.2% on
metformin. Which add-on agent has proven cardiovascular and
heart failure benefit?
A. Sitagliptin
B. Empagliflozin
C. Pioglitazone
D. Glimepiride
Answer: B – SGLT2 inhibitors (empagliflozin, dapagliflozin)
reduce HF hospitalization and CV death in HFrEF, regardless of
diabetes status.
1
,2. A patient with type 2 diabetes and eGFR of 35 mL/min is on
metformin. The nurse practitioner should:
A. Continue metformin at same dose
B. Reduce metformin dose by 50%
C. Discontinue metformin
D. Switch to metformin ER
Answer: C – Metformin is contraindicated when eGFR < 30
mL/min. At eGFR 30–45, continue with caution and reduced
dose. At 35, many guidelines suggest continue but monitor.
However, at 35, some sources recommend stopping or dose
reduction. Best answer: C is most conservative. (Clarify: eGFR <
30 absolute contraindication; 30–45 use with caution.)
3. A 55-year-old with type 2 diabetes and obesity (BMI 38) has
an HbA1c of 7.5% on metformin. Which medication provides the
2
,greatest weight loss?
A. Glipizide
B. Insulin glargine
C. Semaglutide
D. Sitagliptin
Answer: C – GLP-1 receptor agonists (semaglutide, liraglutide)
cause significant weight loss. Sulfonylureas and insulin cause
weight gain. DPP-4 inhibitors are weight neutral.
4. A patient with type 1 diabetes is on insulin lispro and insulin
glargine. He reports recurrent hypoglycemia 2 hours after meals.
The NP should:
A. Increase glargine dose
B. Decrease lispro dose or adjust timing
C. Add metformin
D. Switch to regular insulin
3
, Answer: B – Postprandial hypoglycemia suggests excessive
rapid-acting insulin (lispro) relative to meal size or timing. Adjust
prandial insulin.
5. A 70-year-old with type 2 diabetes and multiple falls is on
glimepiride. The NP should consider changing because:
A. Glimepiride causes weight loss
B. Sulfonylureas increase risk of hypoglycemia in elderly
C. Glimepiride is nephrotoxic
D. It causes lactic acidosis
Answer: B – Sulfonylureas (glimepiride, glyburide) cause
prolonged hypoglycemia, especially in elderly, those with CKD,
or irregular eating.
6. A patient on metformin for 5 years develops new-onset
fatigue and muscle cramps. Lab: BUN 32, Cr 1.5 (baseline 0.9),
4
